Tametra Lynnette Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

69383 Issued in CA

Practice address

2516 Samaritan Dr Ste D
San Jose, CA 95124-4108

Phone

(408) 471-4261

NPI assigned

Aug 10, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jacob's Ladder Therapies

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1558124594
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646438400000",
    "number": "1932653755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 SAMARITAN DR STE D",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244108",
            "telephone_number": "408-471-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 SAMARITAN DR STE D",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244108",
            "telephone_number": "408-471-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAMETRA",
        "middle_name": "LYNNETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2022-03-05",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "GA",
            "license": "743953",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "69383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riahna Johnson
• Sarah E Johnson
• Shelley Marie Johnson, REGISTERED NURSE
• Steven Merlin Johnson, MD
• Tamekia Nicole Johnson
• Tremayna A Johnson
• Vivian D. Brown Johnson, M.A., LMFT# 151679
• Adriana Mercedes Johnston, MA, APCC
• Judy Johnston
• Kristine Evelyn Johnston, DO

• Clinical Social Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.